Hungary is leading in orofacial cancer-related death-rate in Europe, while other oral health parameters as dental caries, tooth loss and advanced gum disease are also in the mid-low level, despite the huge preventive oral health strategies, introduced at the end of the 20-the century. Therefore, ADVOCATE partners from the Semmelweis University, (Budapest) expect promising teamwork in improving oral healthcare statistics in Hungary as well as in the other Eastern European countries.

Picture: Speakers of the 22nd Congress of the Hungarian Association for Cranio-Maxillo-Facial Surgery and Scientific Meeting of Dentists, 29 September 2018. Szeged, Hungary.

By Krisztina Márton, Péter Kivovics, Melinda Madléna

ADVOCATE strives to optimise delivery of oral health and wellbeing to the population in EU Member States. This requires a change in oral health care delivery towards prevention. The change will be achieved by developing a model that promotes a preventive rather than restorative oral health care system: The oral health care model 2020.

It has three main objectives: Design an innovative healthcare system, which promotes chronic disease prevention; Establish a set of harmonised indicators which acknowledge success in the prevention of disease and avoidance of unnecessary treatment; Provide evidence-informed guidance to policy and decision makers for improved health systems planning.

The project is funded by the EU Horizon 2020 programme and is coordinated from University College Cork by Professor Helen Whelton.

One part of the project’s work centres around analysing large volumes of data from oral healthcare insurers in European countries. The project is using big data to see if dental professionals can help push for change towards a more preventive approach. This includes change on an individual level so that members of the public are aware of what measures they can take to prevent oral disease. However, it is oral care professionals who give the public preventive advice and so the project aims to increase the focus on prevention in practice by supporting oral care professionals in delivering effective disease prevention. This approach uses extrinsic and intrinsic motivation to achieve the desired behaviour. Extrinsic motivators will be identified by the project through analysing the impact of historical changes in system design on oral care outcomes, whilst taking account of the context and population characteristics. The comparison of outcomes of diverse oral care systems will also be helpful.

Intrinsic motivation will use a newly developed dashboard which can illustrate variations in oral health, treatment and prevention using both high-level claims data and patient-reported data using an innovative patient engagement application. The dashboard indicators are measures which are considered valid, important and relevant measures for oral health and oral health care and have been developed based on a literature review, an expert meeting, the Delphi method, and a World Café. A diverse stakeholder base was engaged in identifying and defining the most appropriate measures.

Groups consulted included general dental practitioners, patients, insurers, and policymakers from Denmark, Germany, Ireland, Hungary, Netherlands and United Kingdom. The approach is being tested by general dental practitioners in field studies in the six partner countries. Aridhia (one of the partners) has provided a secure electronic template for partners to work on anonymised data. The project’s work in developing an oral healthcare dashboard and a patient app hold clear relevance in these terms. The dashboard brings together data from several European countries, enabling healthcare professionals, policy-makers and the general public to gain deeper insights into important questions around oral healthcare.

As the oral health care delivery system is not as overly complex as other health care systems, the oral health care model 2020 may serve as a blueprint for other health care system reforms.

This abstract was first presented in Hungarian on 29th September 2018 at the 22nd Congress of the Hungarian Association for Canio-Maxillo-Facial Surgery and Scientific Meeting of Dentists Prevention and Public Health Symposium; and at the Romanian Scientifc Dental Congress in Marosvásárhely.